[The trends of population general morbidity in the subjects of the Central Federal Okrug of the Russian Federation].

The article presents the results of analysis of indices of total morbidity of population of the Central Federal Okrug (CFD) of the Russian Federation in 2010-2017. The significant differences in indices of total morbidity between the CFD subjects in certain ICD-10 classes were established. The indices of total morbidity of population during study period (8 years) in the Central Federal District factually didn't altered, while dynamics of indices in other subjects was characterized by multidirectionality. The gap in levels of total morbidity of population in the subjects was significant: from 115,123.6 per 100,000 of population in the Kursk Oblast to 194,404.1 per 100,000 of population in the Orel Oblast. The significant difference in rates of increase/ decrease of indices is noted. Thus, in Moscow decrease rate made up to 10%, while in the Orel Oblast morbidity increased up to 13.1%. Besides, in 2017, the Orel Region took a leadership in rate of increasing of total morbidity in such classes of diseases as infectious and parasitic diseases (39.3%), diseases of blood and blood-forming organs (49.1%), diseases of endocrine system (59,1%), diseases of nervous system (26.8%), diseases of respiratory system (28.2%), diseases of musculoskeletal system (16%), malformations (56%). It is very likely that this trend developed under influence of demographic situation in the subject due to significant increasing of percentage of people older than able-bodied age. The city of Moscow occupies leading position in decreasing of rate of prevalence of diseases and last but one place in level of total morbidity being inferior only to the Kursk Oblast. Thus, in Moscow was noted the most significant decreasing of morbidity in classes of infectious and parasitic diseases (26%) and diseases of digestive system (20.6%). The diseases of blood and blood-forming organs (235.2 per 100,000 population) and mental disorders (2353.5 per 100,000 population) were registered the less. The main contribution into trends of increasing or decreasing of indices is made by persons aged 18 years and older (74.1%).

[The main trends in primary morbidity of population in the subjects of the Russian Federation in 2008-2017].

The analysis of primary morbidity is the most important indicator of detection of population health in every single subject of the Russian Federation in whole Russia. This approach also permits to monitor impact of economic and social processes on the national level. The article presents analysis of primary morbidity in the subjects of the Russian Federation in 2008-2017. The trends are established, the rates of increase and decrease of primary morbidity in every particular subject of the Russian Federation are calculated. The subjects with significant increase of particular classes of diseases according ICD-10 were identified. During last decade, the indices of primary morbidity increased on the whole up to 0.9%. The decrease was registered only in the Central and Privolzhskiy Federal Okrugs (4.3% and -1.6% correspondingly. In the rest of Federal Okrugs increase was registered. The highest level of primary morbidity was registered in the Nenets Autonomous Okrug and the lowest level in the Kabarda-Balkar Republic. Ib 2017, the Altai Kray became a leader in registration of primary morbidity of neoplasms and diseases of endocrine system and the Pensa oblast took the lead in registration of primary morbidity of diseases of cardiovascular system. In 2017, the highest level of morbidity of diseases of respiratory system was registered in the Chukchi Autonomous Okrug and of diseases of ear and mastoid bone in the Republic of North Ossetia - Alania. The increase of morbidity in the mentioned classes of diseases in the particular subjects of the Russian Federation requires consideration of leading specialists and corresponding development of measures concerning morbidity stabilizing.

[The Actual Approaches to Reformation of Medical Organizations Providing Out-Patient Care to Population].

The article presents analysis of the system of organization of primary medical sanitary care in the Russian Federation, its strong and weak aspects are emphasized. The main indices of out-patient care of population and their dynamics are considered. The necessity of system development is substantiated with the purpose of supporting accessibility and quality of medical care in out-patient conditions. The concept of development of organizational functional model of primary medical sanitary care in actual conditions is presented. The main principles of the proposed model are founded on implementation of structural transformation of polyclinics with organization of departments of general practitioner practice, specialized consultative care, medical prevention, diagnostic, medical rehabilitation, medical social care, day-time hospital.

[The methodological prerequisites of elaboration of advanced regional patterns of medical care provision to population].

The article deals with the characteristics of medical demographic indicators, morbidity indicators, public health resources indices and medical care volumes in Federal okrugs. The analysis provided a basis to develop the designed and adjusted standards of main volumetric indicators for territorial programs of public guarantees of free-of-charge medical care to population of the Russian Federation according the Federal okrugs.

[Work quota setting in a phthisiatrician during outpatient reception hours (as a consulting and local physician)].

The study was undertaken to determine a phthisiatrician's man-hours during outpatient hours as a consulting and local physician in the Stavropol Territorial Tuberculosis dispensary. It used an analytical method - man-hours for individual components of work, i.e. working operations at photochronometric monitoring. The latter of the work of two consulting physicians and two local ones (two working weeks per specialist) was made. The 2006 phthisiological care schedule envisaged 185.6 visits per 1,000 dwellers. If these data are taken as the basis, then 0.64 of the position of a phthisiatrician per 10,000 is required to deliver health care to patients with tuberculosis, by taking into account the work quota setting developed in this study. An expert evaluation was to substantiate the labor hours of a phthisiatrician when he delivered outpatient health care to patients with tuberculosis. Expertise of the substantiation of the labor hours of a phthisiatrician delivering outpatient health care to patients with tuberculosis has revealed that the maximum working time spent by the phthisiatrician on medical documentation work, to the prejudice of the quality of patient examination, the raising the level of his skills, and the performance of preventive work among the patients.

[Regional evaluation of the state of population health protection]. / Regional'naia otsenka sostoianiia okhrany zdorov'ia naseleniia.

The paper contains theoretical provisions and methods of information supply of public health programmes under conditions of the improvement of management and broadening of independence of local public health bodies. Emphasis is being placed on the role of fundamental studies in the formation of population's health and methods of multifactor analysis permitting to identify regional health problems and to substantiate priority measures. There is a discussion of the system of health indices and activities of public health bodies and institutions which are to be used in economic methods of management along with the evaluation of health programmes efficiency according to the ultimate results. Periodic probe investigations of health problems and the degree of population's satisfaction with health care contribute considerably to this practice. The materials of the complex study of population's health in connection with the 1989 census of the population in many respects meet these requirements and the paper provides ways for the organization and cooperation with the chairs of social hygiene while carrying out this large-scale study.

[Improving the information supply of a polyclinic]. / Sovershenstvovanie informatsionnogo obespecheniia polikliniki.

The article provides a description of a new statistical information supply of a polyclinic based on a special registration form--"An ambulatory patient coupon". The peculiarities and advantages of this document are demonstrated, some findings are provided.

[The selection of the territories for conducting epidemiological research on the prevalence of skin and venereal diseases]. / Otbor territorii dlia provedeniia épidemiologicheskikh issledovanii rasprostranennosti kozhnykh i venericheskikh zabolevanii.

The results of studies aimed at the formation of representative territories at republics, regions, and cities for the epidemiologic surveys are analyzed. The representative areas that were singled out in these studies are recommended to be used for research in dermatology and venereology, aimed at the population health fortification.

[Possibility of modeling regional characteristics of the level and structure of morbidity and the utilization of medical services by the population]. / Vozmozhnost' modelirovaniia territorial'nykh osobennostei urovnia i struktury zabolevaemosti i nuzhdaemosti naseleniia v meditsinskoi pomoshchi.

The feasibility of modelling the annual level and the pattern of gerenal morbidity (applications for aid) of the population according to the data on a single application for aid during one month of the year was based on the established regularities of seasonal changes in patients' applications for aid. It was established that an average day level of applications for aid each month in relation to average annual levels was a constant value governed by the peculiarities of seasonal distribution and irrespective of the value of the intensive morbidity indicator in the region. Distribution of applications for medical aid by week days also appeared to be constant. Proceeding from the data on population's applications for aid during 2-4 days the proposed system of coefficients enabled one to obtain the necessary information on the regional character of population's morbidity and various health care needs, thus it became possible to assess adequacy of the level of medical services to the population's health care needs in this region and also to supply information on various analytical, managerial, and planned standard problems. Experimental examination of feasibility and reliability of the model development of the level and pattern of general morbidity on the basis of a single registration of regional consultation rates was tackled by means of computer-based registration of the morbidity of 25,000 residents of Kineshma, the Ivanov Region.